go back

South Dakota rates for HCPCS G0455

Preparation With Instillation Of Fecal Microbiota By Any Method Including Assessment Of Donor Specimen

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.69 / $130.77 / $130.77
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.10 / $147.07 / $254.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.90 / $167.80 / $302.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.48 / $177.73 / $250.94